Healthcare Provider Details

I. General information

NPI: 1720166986
Provider Name (Legal Business Name): ANGELA M. ALLEVI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 CHESTNUT STREET EAST , SUITE 300 JEF FACULTY PEDS AND DUPONT CHILDRENS HLTH PROG
PHILADELPHIA PA
19107-4405
US

IV. Provider business mailing address

P.O. BOX 191
ROCKLAND DE
19723-0191
US

V. Phone/Fax

Practice location:
  • Phone: 215-861-8800
  • Fax: 215-861-8815
Mailing address:
  • Phone: 302-651-4000
  • Fax: 302-651-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD424408
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD424408
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD424408
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: